Intravenous or IV therapy involves administration of liquids directly into a patient's veins through an inserted catheter. Long-term, continuous IV therapy (for administrating chemotherapy regimens, frequent drawing of blood samples, antibiotic regimens, or tube feeding [parenteral nutrition]) is usually accomplished with a peripherally inserted central catheter line (or PICC line), or through a more central location with a central venous catheter or a Broviac catheter.
A PICC line is a soft, flexible tube, with one or more internal lumens. The PICC line is surgically inserted into a peripheral vein, often the arm, in a sterile procedure that must be undertaken by a trained medical professional. During insertion, the PICC line is drawn upward with an inserted guide wire until the tube is in, or proximate to, the superior vena cava of the heart. PICC lines are usually inserted 25 to 60 cm within a patient's peripheral vein.
A central venous catheter is a soft, flexible tube, with one or more internal lumens that has a larger diameter than a PICC line. A Broviac catheter is a central venous catheter with a smaller lumen for use with small children. The central venous catheter is placed directly into a large vein in the neck, chest, or groin.
PICC lines can remain in situ for extended periods of time, from days to a year. PICC lines and central venous catheters are more patient-friendly, because they necessitate only one tube insertion, rather than repeated ones.
Once the PICC line or the central venous catheter is inserted, the guide wire is removed and a small length of the PICC line or the central venous catheter remains external to the patient, extending outwards from the point of insertion. The external end of the PICC line or the central venous catheter is capped to prevent bacteria, viruses or contaminants from entering.
This small length of the PICC line or the central venous catheter often dangles, unsupported, near the point of insertion. There is a constant danger of pulling or otherwise interfering with the PICC line or the central venous catheter during normal daily activities or during sleep. Tape is generally used to secure the tubes while not in use. These tapes can lead to pain, inflammation, infections, and reduced drug efficacy. The problem in movement is especially pronounced in young children undergoing long-term therapy with a PICC line or a central venous catheter.
Thus, this small length of the PICC line or the central venous catheter, and the end cap, must be attached to the patient to prevent movement or dislodgment of the internal tubing. This movement or dislodgment may prevent the administered liquids from reaching the desired veins, or cause significant inflammation to the insertion point, air embolisms, arterial punctures, internal bruising, and blood clots.
The PICC line or the central venous catheter external attachment must also protect the tubing from being pierced or otherwise punctured due to movement. A pierced or punctured PICC line or central venous catheter, would not only prevent administered liquids from reaching the desired veins, it may also allow bacteria or contaminants to enter, causing internal infections in the patient.
Previous solutions to prevent movement of the PICC line or the central venous catheter have included taping the external small length of the lines with various medical tapes. These tapes often leave adhesive residues that are irritating to the skin. These irritations can often lead patients to inadvertently scratch the insertion points, thereby moving the small length of the external PICC line or the central venous catheter. Some newer medical tapes reduce or virtually eliminate adhesive residue, but these tapes are not as strong and still irritate the skin surrounding the insertion point. Furthermore, this medical tape must often be partially removed to access the PICC line or the central venous catheter and then re-taped once the IV therapy is complete. This removal of the tape and re-taping to the skin can result in significant irritation. Moreover, when the end of the PICC line or the central venous catheter is taped visibly from the outside of the patient's clothing, it presents an unsightly and disturbing appearance that can produce mental distress.
Accordingly, there is a need for a protective sleeve to protect the PICC line or the central venous catheter insertion points. This sleeve needs to be easily attached to a patient's arm or body, secure the small length of the external PICC line or the central venous catheter, protect the tubing and cap from external contaminants, and allow easy access to the PICC line or the central venous catheter for administration of drugs or nutrients, and access for blood draws. This sleeve must also allow the patient freedom of movement and be comfortable enough to prevent skin irritation over long-term usage.